Individual Placement and Support and Participatory Workplace Intervention on the Work Participation of People with Disabilities: A Randomised Controlled Trial.

PURPOSE: This study assessed the effectiveness of Individual Placement and Support (IPS), Participatory Workplace Intervention (PWI), and IPS + PWI on work participation and health of people with work disabilities. METHODS: A randomised controlled 2 × 2 factorial trial with 120 clients and an 18-month follow-up was performed. Differences between IPS and no-IPS and between PWI and no-PWI were assessed using log-rank tests and Cox proportional hazards models. RESULTS: In the IPS group, restricted mean survival time (RMST) for sustainable paid employment was 352 days, compared to 394 in the no-IPS group (HR = 1.47, 95% CI = 0.81-2.63). In the PWI group the RMST was 378 days, compared to 367 in the no-PWI group (HR = 0.89, 95% CI = 0.48-1.64). For the secondary outcome 'starting any paid employment, a trial placement, or education' RMST was significantly lower for the IPS group (222 days) than for the no-IPS group (335 days; HR = 1.85, 95% CI = 1.01-3.42). Mental health was significantly lower (worse) in the PWI group (difference -4.07, 95% CI = -7.93 to -0.22) than in the no-PWI group. For all other secondary outcomes, no statistically significant differences were found. CONCLUSION: No statistically significant differences were observed in the duration until starting sustainable employment between IPS and no-IPS, and between PWI and no-PWI. The duration until starting any paid employment, a trial placement, or education was shorter in the IPS group than in the no-IPS group, but further research should explore whether this also increases sustainable employment in the longer term.

Process Evaluation of Individual Placement and Support and Participatory Workplace Intervention to Increase the Sustainable Work Participation of People with Work Disabilities.

PURPOSE: This study is a process evaluation of the use of Individual Placement and Support (IPS) and Participatory Workplace Intervention (PWI) to increase the work participation of people with work disabilities. We ran the evaluation alongside a randomized controlled trial (RCT), to investigate whether and to what extent IPS and PWI were executed according to protocol. METHODS: The study population consisted of clients with work disabilities, and their job coaches who were employed by the municipality of a large city in the Netherlands. Data were collected between September 2019 and November 2022 using registration forms, accompanied by researchers' notes and logbooks. RESULTS: For IPS the dose delivered was reasonable and the IPS fidelity measurement score was fair. The job search focused on paid work for almost all clients and was based on their wishes as indicated in the protocol, but integration of employment services with (health) care was often lacking. A minority of the clients who were assigned to PWI received the intervention, often because the client did not start work within the follow-up period and a workplace was a requirement to apply the intervention. CONCLUSION: The results of this study show that IPS was executed reasonably and with a fair fidelity, which indicated implementation was sufficient to find an effect on work participation in the RCT. PWI was barely realized in practice and no conclusions regarding the fidelity could be drawn. We therefore conclude that we cannot expect PWI to have any effect on work participation in the RCT.

A single infusion of MDCO-216 (ApoA-1 Milano/POPC) increases ABCA1-mediated cholesterol efflux and pre-beta 1 HDL in healthy volunteers and patients with stable coronary artery disease.

AIMS: Apolipoprotein A-1 (ApoA-1), based on epidemiology, is inversely associated with cardiovascular (CV) events. Human carriers of the ApoA-1 Milano variant have a reduced incidence of CV disease. Regression of atherosclerotic plaque burden was previously observed on intravascular ultrasound (IVUS) with ETC-216, a predecessor of MDCO-216. MDCO-216, a complex of dimeric ApoA-1 Milano and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine, is being developed to reduce atherosclerotic plaque burden and CV events. We investigated the efficacy and safety of a single infusion of MDCO-216 in healthy volunteers and in patients with coronary artery disease (CAD). METHODS AND RESULTS: Twenty-four healthy volunteers and 24 patients with documented CAD received a 2-h infusion of MDCO-216 in a randomized, placebo controlled, single ascending dose study. Five cohorts of healthy volunteers and four cohorts of CAD patients received ApoA-1 Milano doses ranging from 5 to 40 mg/kg. Subjects were followed for 30 days. Dose-dependent increases in ApoA-1, phospholipid, and pre-beta 1 HDL and decreases in ApoE were observed. Prominent and sustained increases in triglyceride, and decreases in HDL-C, endogenous ApoA-1 and ApoA-II occurred at doses >20 mg/kg and profound increases in ABCA1-mediated cholesterol efflux were observed. Other lipid and lipoprotein parameters were generally unchanged. MDCO-216 was well tolerated. CONCLUSIONS: MDCO-216-modulated lipid parameters profoundly increased ABCA1-mediated cholesterol efflux and was well tolerated. These single-dose data support further development of this agent for reducing atherosclerotic disease and subsequent CV events.

The thienotriazolodiazepine Ro 11-1464 increases plasma apoA-I and promotes reverse cholesterol transport in human apoA-I transgenic mice.

BACKGROUND AND PURPOSE: Ro 11-1464 is a thienotriazolodiazepine previously described to selectively stimulate apolipoprotein A-I (apoA-I) production and mRNA level in human liver cells. Here, we studied its effects upon oral administration to human apoA-I transgenic (hapoA-I) mice. EXPERIMENTAL APPROACH: HapoA-I mice were treated for 5 days with increasing doses of Ro 11-1464. Macrophage reverse cholesterol transport (mph-RCT) was assessed by following [(3) H]-cholesterol mobilization from pre-labelled i.p. injected J774 macrophages to plasma, liver and faeces. Effects on plasma lipids, apoproteins, lecithin-cholesterol : acyltransferase (LCAT) and liver enzymes, as well as on faecal excretion of cholesterol and bile salts, and on liver lipids and mRNA contents were determined. KEY RESULTS: Treatment with Ro 11-1464 300 mg·kg(-1) ·day(-1) resulted in a nearly 2-fold increase in plasma apoA-I, a 2- to 3-fold increase in the level of large sized-pre-ß high-density lipoprotein and a 3-fold selective up-regulation of hepatic apoA-I mRNA, but a marked decrease in all plasma lipids and LCAT activity. Mpm-RCT was decreased in blood but markedly increased in faecal sterols (4-fold) and bile acids (1.7-fold). However, liver weight and liver enzymes in plasma were also increased, in parallel with an increase in liver cholesterol ester content (all these effect being significant). CONCLUSION AND IMPLICATIONS: In this model Ro 11-1464 causes increased hepatic expression and plasma levels of apoA-I and a suppression of LCAT, and a marked enhancement of reverse cholesterol transport, but also some symptoms of liver toxicity. The compound may therefore be a prototype for a next generation of anti-atherosclerotic medicines.

Atomic-size oscillations in conductance histograms for gold nanowires and the influence of work hardening.

Nanowires of different natures have been shown to self-assemble as a function of stress at the contact between two macroscopic metallic leads. Here we demonstrate for Au wires that the balance between various metastable nanowire configurations is influenced by the microstructure of the starting materials, and we discover a new set of periodic structures, which we interpret as due to the atomic discreteness of the contact size for the three principal crystal orientations.

Evaluation of sample spin-polarization from spin-polarized scanning tunneling spectroscopy experiments.

Spin-polarized scanning tunneling microscopy has produced a great amount of images presenting magnetic contrast between different magnetic domains with an unsurpassed spatial resolution but getting values like the surface polarization has proven to be a difficult task. We will discuss in detail how to extract this information for the case of manganese layers grown on Fe(001) whiskers. Mn layers adopt a body-centered-tetragonal (bct) structure when they are grown on the Fe(001) surface at room temperature. The Mn layers show an antiferromagnetic coupling between the layers. Comparing our spin-polarized scanning tunneling spectra measured with Fe-coated W tips with spin-resolved band structure calculations, we are able to find the value of the sample surface polarization. Also discussed is a method to change the tip magnetization. Finally, the magnetic structure around a screw dislocation on the surface is reviewed.

Amblyopia & Strabismus Questionnaire: design and initial validation.

Literature on the benefits of screening and treatment of amblyopia emphasizes the costs of insufficiently treated amblyopic patients who lose their better eye. However, patients with insufficiently treated amblyopia and strabismus who do not lose their better eye only experience a slight decrease in their quality of life, and such patients occur more frequently. We designed and validated a questionnaire for amblyopia and strabismus in order to assess the decrease in quality of life of such patients. Complaints were collected from outpatients and reduced to five domains, pertaining to distance estimation, visual disorientation, problems with social contacts and cosmetic problems, diplopia, and fear of losing the better eye. For these domains 26 questions were formulated that constitute the Amblyopia & Strabismus Questionnaire (A&SQ). The A&SQ, the National Eye Institute Visual Function Questionnaire-25 (VFQ-25) and the Short Form-12 Health Survey (SF-12) were presented to 53 healthy controls, 68 outpatients and a cohort of 174 outpatients born between 1962 and 1972 and treated between 1968 and 1974 for amblyopia and strabismus. The quality of life was best in healthy controls and worst in current outpatients, not only on the SF-12 and the VFQ-25 but also on the A&SQ, demonstrating an acceptable construct validity of the A&SQ. The decrease in the quality of life as measured by the A&SQ was most outspoken in our outpatient group of amblyopia and strabismus patients, less in the cohort that had been treated 30 years previously and least in the healthy controls, demonstrating an acceptable discriminatory validity of the A&SQ.

Fractional conductance in hydrogen-embedded gold nanowires.

Interaction of the physically adsorbed molecular hydrogen with a breaking gold nanowire results in additional stable atomic configurations in few atom contacts and appearance of fractional peaks in the conductance histogram. This effect is explained by peculiar dynamic evolution of the hydrogen-embedded nanoconstriction due to competition between tensile and capillary forces. Dimerization within the atomic wire and hydrogen-assisted stabilization of gold dimers results in preferable atomic arrangements with conductivity close to 0.5 and 1.5 of quantum conductance unit G(0)=2e(2)/h.

Observation of spin-polarized surface states on ultrathin bct Mn(001) films by spin-polarized scanning tunneling spectroscopy.

We report the observation of a magnetic contrast of up to 20% in the scanning tunneling spectroscopy dI/dV maps obtained with Fe-coated tips on Mn(001) layers grown on an Fe(001) whisker at 370 K. These nanometer resolution microscopy results show that the layers couple antiferromagnetically. By normalizing the dI/dV curves by tunneling probability functions, we found a spin-dependent peak on the body-centered-tetragonal (bct) Mn(001) surface at +0.8 V, whose high spin polarization gives rise to the dI/dV map contrast. Band structure calculations allow one to identify the +0.8 V peak as due to two spin-polarized d(z(2)) surface states.

Effects of crystal shape on the energy levels of zero-dimensional PbS quantum dots.

Nanometer-size PbS quantum dots have been made by electrodeposition on a Au(111) substrate. The deposited nanocrystals have a flattened cubic shape. We probed the single-electron energy-level spectrum of individual quantum dots by scanning tunneling spectroscopy and found that it deviates strongly from that of spherical PbS quantum dots. The measured energy-level spectrum is successfully explained by considering strong confinement in a flattened cubic box.

Real-space imaging of an orbital Kondo resonance on the Cr(001) surface.

The Kondo effect is usually connected with the interaction between a localized spin moment and itinerant electrons. This interaction leads to the formation of a narrow resonance at the Fermi level, which is called the Abrikosov-Suhl or Kondo resonance. Scanning tunnelling microscopy is an ideal technique for real-space investigations of complicated electronic structures and many-body phenomena, such as the formation of the Kondo resonance or d-wave pairing in high-T(c) superconductors. Theory has predicted that similar, Kondo-like many-electron resonances are possible for scattering centres with orbital instead of spin degrees of freedom--the quadruple momenta in uranium-based compounds or two-level systems in metallic glasses are examples of such 'pseudo-Kondo' scattering centres. Here we present evidence for the orbital Kondo resonance on a transition-metal surface. Investigations of an atomically clean Cr(001) surface at low temperature using scanning tunnelling microscopy reveal a very narrow resonance at 26 meV above the Fermi level, and enable us to visualize the orbital character of the corresponding state. The experimental data, together with many-body calculations, demonstrate that the observed resonance is an orbital Kondo resonance formed by two degenerate d(xz), d(yz) surface states.

Direct observation of surface alloying and interface roughening: growth of Au on Fe(001).

Scanning tunneling microscopy studies on the growth of Au on Fe(001) are reported. A surface alloy is observed for submonolayer deposition ( <0.5 monolayer) at temperatures higher than 370 K. This surface-confined alloy demixes when it is covered with Au and in combination with imperfect layer-by-layer growth a rough interface consisting of Au islands in and Fe islands on the original Fe(001) substrate is created. A real-space high resolution study of this buried interface is possible because of the large difference in interlayer spacing between bcc Fe(001) and fcc Au(001).

Influence of impurities on localized transition metal surface states: scanning tunneling spectroscopy on V(001).

The first scanning tunneling spectroscopy measurements on V(001) are reported. A strong surface state is detected which is very sensitive to the presence of segregated carbon impurities. The surface state energy shifts from 0.03 eV below the Fermi level at clean areas towards higher energies (up to approximately 0.2 eV) at contaminated areas. Because of the negative dispersion of this state, the upward shift cannot be described in a simple confinement picture. Rather, the surface state energy is governed by vanadium surface s- d interactions which are altered by carbon coverage.

Optical detection of ballistic electrons injected by a scanning-tunneling microscope.

We demonstrate a spectroscopic technique which is based on ballistic injection of minority carriers from the tip of a scanning-tunneling microscope into a semiconductor heterostructure. By analyzing the resulting electroluminescence spectrum as a function of tip-sample bias, both the injection barrier height and the carrier scattering rate in the semiconductor can be determined. This technique is complementary to ballistic electron emission spectroscopy since minority instead of majority carriers are injected, which give the opportunity to study the carrier trajectory after injection.